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Healthcare Exchange: States that do not cover Bariatric Sugery

*States that do not offer bariatric surgery, nutrition counseling, or weight loss programs in the State Health Insurance Marketplace are:

  • Alabama
  • Alaska
  • Florida
  • Georgia
  • Indiana
  • Kansas
  • Kentucky
  • Minnesota
  • Mississippi
  • Missouri
  • Nebraska
  • Pennsylvania
  • South Carolina
  • Wisconsin

Source

http://nofusa.org/news/health-insurance-cover-obesity-treatment/

  • Replies 15
  • Views 3.4k
  • Created
  • Last Reply

Featured Replies

  • 2 weeks later...

How is possible that some state allow the surgery and others don't? Total BS. Is there any way to make insurance pay for surgery even if they say they don't cover it?

  • Author

Those states do not deem it essential services. If you have a plan from the Healthcare exchange I doubt you can make them cover something they are not required to cover by law.

  • 2 weeks later...

Idaho Marketplace plans will cover nutritional counseling only, not any sort of bariatric surgery.

Actually only 23 states cover surgery.

  • 2 weeks later...

I didn't think Texas covers it.

How is possible that some state allow the surgery and others don't? Total BS. Is there any way to make insurance pay for surgery even if they say they don't cover it?

According to a phone call I made to my State's (Kentucky) Insurance Commissioner a while back, the requirements are based in state law. To have it included would literally take an act of the state legislature.

  • 2 months later...

I posted a new thread today with more explanation of the disparities between the states here: http://www.bariatricpal.com/topic/367858-which-us-states-dodont-cover-bariatric-surgery-answers-here/

...before I saw that surfergirl had started this thread. So if you want more details, click.

  • Author

What insurance do you have? All the literature that I have found says it is not covered in Kentucky. Medicaid plans might cover it since Medicaid is federal and not state.

What insurance do you have? All the literature that I have found says it is not covered in Kentucky. Medicaid plans might cover it since Medicaid is federal and not state.

I believe you are correct. It is my experience that the non-Medicaid insurance in Kentucky doesn't have it. Of course, if our new so-called "Governor" has anything to say about it the Medicaid coverage will probably go away, too.

  • Author

Medicaid plans aren't the kind of Healthcare plans we are talking about in this thread.

Medicaid is federal. We are talking about individual or family plans that consumers purchase on the Healthcare exchange for the self employed or people who do not have insurance offered by their employer.

Check my thread - linked on the previous page - about the Medicaid/Exchange/private relationship.

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